Is medication required in prehypertensive patient?

Question

Hello doctor,

I am 25 years old. My blood pressure generally ranges between 125/60 mmHg and 133/65 mmHg. Sometimes if I am nervous, my BP goes up to 145/80 mmHg. When I am calm, my BP usually stays at 117/60 mmHg. Should I take BP medicine like Propranolol for hypertension? I have already made changes in my lifestyle. I do not drink or smoke and I avoid sodium. I am also practicing meditation. Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have noted all your details.

Increased anxiety and overthinking stimulate the autonomous nervous system in the body which increases blood pressure momentarily even if lifestyle modification has been tried.

I suggest you take a low dose of Benzodiazepines, Clonazepam 0.25 mg once daily at night along with a low dose of beta-blocker like Propranolol (Ciplar 10 mg) for 21 days along with lifestyle modification. Consult your specialist doctor, discuss with him or her, and take medicines with consent. Monitor your blood pressure every third day.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.

Answer 2

Hi

Welcome back to icliniq.com.

When you are nervous your blood pressure is 145 systolic and your diastolic pressures are normal. So, our target is to achieve a systolic blood pressure of less than 120 mmHg. A low dose of Propranolol and Clonazepam are not going to lower your diastolic blood pressure so, you do not have to worry about that.

According to the JACC (Journal Of American College of Cardiology), the blood pressure is categorized as normal BP for less than 120/80 mmHg. Prehypertensive state when it ranges between 120-139/80-89 mmHg.

Grade 1 (mild hypertension) when it ranges between 140-159/90-99 mmHg.

Grade 2 (moderate hypertension) when BP is between 160-179/100-109 mmHg.

Grade 3 (severe) when the BP is above 180/110 mmHg.

You fall in the category of a prehypertensive state. Severe lifestyle modification plus a low dose of anti-anxiety medication and a low dose of Propranolol will help to revert back from the prehypertensive state to normotensive state. A low-dose anti-anxiety medication has no apparent side effects when administered for a short period of time.

Along with the medications, I would advise you 45 minutes of strenuous exercises every day for three months and a 1500 mg sodium diet. Include a lot of fiber and fruits in your diet. Avoid butter and saturated fats instead use olive oil to cook. 30 minutes of brisk walking at a speed not less than 5.1 km/hr has to be done. Keep a record of your blood pressure every third day for 21 days. Once you achieve your target blood pressure you would be weaned off the medicines. I suggest you take Clonazepam 0.25 mg once daily at 9 pm and tablet Ciplar (Propranolol) 10 mg once daily at 9 am after breakfast for 21 days.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.

Answer 3

Hi,

Welcome back to icliniq.com.

Welcome.

Please do not hesitate to contact us for further doubts.

Thank you.